Active NPI
Sandra Seidlitz
- Clinical Social Worker
- Berkeley, CA
National Provider Identifier
1346647187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS10878
- Practice address
- 925 The Alameda
Berkeley, CA 94707-2310 - Phone
- (510) 526-4859
- NPI assigned
- Nov 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCS10878 | CA | |
| Clinical Social Worker | 1041C0700X | LCS10878 | CA | Primary |
Addresses
Primary practice location
925 The Alameda
Berkeley, CA 94707-2310
Mailing address
925 The Alameda
Berkeley, CA 94707-2310
Phone (510) 526-4859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2017 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS10878 | CA | MD | Clinical Social Worker |
| 10878 | CA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416528000000",
"number": "1346647187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 THE ALAMEDA",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072310",
"telephone_number": "510-526-4859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 THE ALAMEDA",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072310",
"telephone_number": "510-526-4859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIDLITZ",
"first_name": "SANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-21",
"last_updated": "2014-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LCS10878",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS10878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.